Biggest Success? DCF Overhaul

May 5, 2014

The 2014 Florida Legislature passed a number of bills relating to health care, most of them modest in scope. 

Credit Florida House of Representatives

But at least one that passed will probably save lives: the Child Welfare Act, which in part responds to the deaths of 477 children who were supposed to be under the protection of the Department of Children and Families.

The DCF overhaul had already begun before the session, but was intensified after the Miami Herald published the series Innocents Lost.

Sen. Eleanor Sobel, who muscled the enormous bill through, was celebrating at the beach when Health News Florida spoke to her Sunday. She said the bill was a “heavy lift,” but worth every bit of work. At one point, DCF and some of its private contractors tried to water the bill down, saying it cost too much, and some reports said the office of Gov. Rick Scott had a hand in that.

But after an outcry by child advocates, Sobel and other lawmakers put a stop to it.

“We have to focus on what’s in the best interest of children,” said Sobel, D-Hollywood.

During the session, more health bills failed than passed.  But here is a round-up of health-related bills that passed both houses of the Legislature and have gone to Gov. Rick Scott (Editor's note: One bill that was previously included in this list, HB 7177 on the prescription drug database, actually died late Friday.)

Child Protection: SB 1666 overhauled the way DCF and its contractors respond to complaints about children in danger, placing a child’s welfare over the interest of keeping families together. Also the budget appropriated $47 million more for child protection, with more than half of the funds paying for investigators to reduce caseloads. Both the House and Senate passed the bill unanimously.

Compounded Drugs: HB 7077 closes a loophole in Florida law that posed a significant danger to the public from out-of-state compounding pharmacies, which make drugs and ship them to hospitals and clinics in Florida.  Current law allows the Department of Health to license and inspect only those compounders based in Florida, but hundreds of compounders in other states also have Florida licenses.

DOH took a survey after the New England Compounding Pharmacy in 2012 caused an outbreak of fungal meningitis that killed scores of patients in many states, including Florida. Hearings and work by the Board of Pharmacy determined that pharmacies that make “sterile” drugs – usually liquid drugs that must be kept sterile because they enter the bloodstream – must be required to get a permit.

But while the Board of Pharmacy could require that of pharmacies in-state, the loophole eliminated the requirement for those based out-of-state. (See: Time to Fix Glitch in Pharmacy Law?)

Nursing home expansion: HB 287 lifted a 13-year moratorium on adding nursing home beds and changes the methodology under which the state assesses need for beds.

Nursing home lawsuits: SB 670 shields investors in nursing home companies from lawsuits alleging abuse or negligence and makes it harder to sue nursing homes for punitive damages.  On the other hand, it makes it easier to revoke the license of a nursing home for failing to pay a judgment and requires the homes to provide the required records to a patient’s attorney. (See more on limits on nursing home lawsuits.)

Exploitation: HB 409 increases the penalties for taking advantage of vulnerable elderly or disabled persons.

Low-THC Cannabis: SB 1030 sets up a state-run framework for prescribing a marijuana-plant extract to children who have intractable seizures. The extract, sometimes referred to as “Charlotte’s Web” after one of the early products from Colorado, can be prescribed only by physicians who have gone through special training.

It is low in THC, the chemical responsible for the “high” that marijuana produces, but is rich in CBD, which seems to reduce seizures and symptoms of several serious diseases, although most are not covered in this bill. (See DOH to Build Marijuana-Drug System

E-Cigarettes: SB 224 bars the sale of electronic cigarettes to minors, and allows local governments to enact ordinances to restrict sales. For more, see Lawmakers Poised to Ban E-cig Sales to Kids.

EpiPens: HB 1131 allows epinephrine auto-injectors – EpiPens for short—to be stocked in restaurants, theme parks and other places where they may be needed for anaphylactic shock triggered by food allergies.  See: ‘EpiPen Bill Headed to Scott'.

Abortion: HB 1047 requires doctors to determine if a pregnancy has advanced to the point that the fetus is viable, or may be able to survive if it were born. If so, the bill prohibits them from performing an abortion. Current law makes abortion illegal at 24 weeks; the new law is predicted to  move that back by two to four weeks. The bill also tightens conditions under which a third-trimester abortion can be performed, allowing it only if denying it could lead to the death or loss of a major bodily function of the pregnant woman.   

Fetal Injury: HB 59 makes it a crime to kill or harm a fetus. It was prompted by a Tampa case, in which a man tricked his pregnant girlfriend into taking a pill that led to the death of the fetus.

Pharmacy: HB 323 reconfigures the make-up of the Board of Pharmacy, adding representatives from community drug stores. It also initially intended to expand the number of pharmacy technicians that a pharmacist can supervise.  However, Sen. Denise Grimsley, R-Sebring, amended it to say that the ratio remains one-to-one unless the Board of Pharmacy decides it is safe to have more.  Chain drugstores had asked for the number to be greatly expanded, citing new technology that makes supervision of multiple technicians easier, but opponents argued that the Legislature could not safely impose a one-size-fits-all ratio.

Alzheimer's Disease: HB 709by Rep. Matt Hudson, R-Naples, sets up a grant and fellowship program within DOH and requires the Department of Emergency Management to designate special-needs shelters for people who have memory disorders.